CARES ACT Stimulus Package

The CARES Act legislation, established to provide relief to American families, workers, and the heroic healthcare providers on the frontline of the COVID-19 outbreak, is on track to distribute $100 billion to healthcare providers, including hospitals battling this disease.

In allocating the funds, the U.S. Health and Human Services Division (HHS) is working to address both the economic harm across the entire healthcare system due to the stoppage of elective procedures, and addressing the economic impact on providers incurring additional expenses caring for COVID-19 patients, and to do so as quickly and transparently as possible.

GENERAL ALLOCATION

To expedite providers getting money as quickly as possible, $30 billion was distributed immediately, proportionate to providers' share of Medicare fee-for- service reimbursements in 2019.

On Friday, April 10, $26 billion was delivered to bank accounts. The remaining $4 billion of the expedited $30 billion distribution was sent on April 17.

HHS will begin distribution of the remaining $20 billion of the general distribution to these providers to augment their allocation so that the whole $50 billion general distribution is allocated proportional to providers' share of 2018 net patient revenue.

On April 24, a portion of providers will automatically be sent an advance payment based off the revenue data they submit in CMS cost reports. Providers without adequate cost report data on file will need to submit their revenue information to a portal opening this week at https://www.hhs.gov/providerrelief for additional general distribution funds.

Providers who receive their money automatically will still need to submit their revenue information so that it can be verified.

Payments will go out weekly, on a rolling basis, as information is validated, with the first wave being delivered at the end of this week (April 24, 2020).

According to the American Medical Association (AMA), the CARES Act summary has expanded provisions for small businesses, which includes physician practices, with no more than 500 employees eligible to apply for the Small Business Administration’s (SBA) section 7(a) Payroll Protection Program.

The bill now includes another provision that affects small businesses by providing small businesses with more than one physical location eligible for each location as long as it has no more than 500 employees per physical location.

AMA received clarification that this second provision would not apply to physician practices; therefore, AMA amended the summary. In addition, AMA is in the process of developing more in-depth resources for physicians on Medicare advance payments, SBA loans, and medical liability that will be available soon. The updated summary is available here.

March 30, 2020

Congress passed and the President signed the CARES Act, a $2 trillion relief package that provides much needed economic relief for American families and businesses who are hurting. This legislation will provide assistance to America’s heroic healthcare workers who are on the frontlines of this outbreak, including $100 billion which will go to healthcare providers, including hospitals on the front lines of the COVID-19 pandemic, $27 billion which will go to bolstering life-saving capabilities, including developing vaccines and the development, purchase, and distribution of critical supplies and $45 billion which will go to the Federal Emergency Management Agency Disaster Relief Fund, more than doubling the amount available to support the President’s Emergency and Disaster Declarations to empower State, local, and tribal leaders to effectively respond.

Provisions of particular interest to physicians and their practices include the following:

Creates a new loan product within the Small Business Administration for loans of up to $10 million to help cover payroll and overhead costs, with expanded loan forgiveness criteria. Physician practices with not more than 500 employees may qualify.

$100 billion in direct financial support to hospitals, physician practices, and other health care providers under the Public Health and Social Services Emergency Fund. This support is for costs of treating COVID-19 patients as well as to ease the financial impact on those who lose revenue due reductions in other services as a result of the pandemic. Exact eligibility criteria and application process is not yet defined pending implementation.

A temporary waiver of the face-to-face visit requirement with home dialysis patients.

Authority for the Secretary of HHS to waive telehealth coverage requirements for new patients during a national emergency. Previous legislation provided flexibility only for established patients seen within the past three years.

Secretary will also allow for enhanced use of telehealth under Medicare for federally qualified health centers.

Also of interest, the "health extenders" package that was set to expire on May 22 has now been extended to Nov. 30. For a complete summary once the bill is signed into law, visit the AMA COVID-19 website.